Obesity and Asthma: An Intriguing Link in Childhood and Adolescence

2021 ◽  
pp. 1-4
Author(s):  
Maria Angela Tosca ◽  
Irene Schiavetti ◽  
Giorgio Ciprandi ◽  
Keyword(s):  
Lung Function ◽  
Children And Adolescents ◽  
Asthma Control ◽  
Large Population ◽  
Test Body ◽  
Childhood And Adolescence ◽  
Asthma Control Test ◽  
Children With Asthma ◽  
Prevalence Of Obesity ◽  
Obesity In Children

<b><i>Background:</i></b> Asthma is a chronic disease characterized by airway inflammation. Obesity is common and may be associated with asthma. <b><i>Objective:</i></b> The objective of this study is to investigate the possible relationship between asthma control and obesity in children. <b><i>Methods:</i></b> A nationwide study included 462 children and adolescents, 319 (69%) males, mean age 11.3 years. Asthma control grade, asthma control test, body mass index calculated as percentiles, and lung function were evaluated. <b><i>Results:</i></b> Obesity affected 64 (13.9%) children with asthma. This outcome underlined the high prevalence of obesity in children and adolescents with asthma. On the other hand, obesity did not affect the asthma control as well as lung function. <b><i>Conclusion:</i></b> This study showed that body weight did not affect asthma control and lung function in a large population of children and adolescents with asthma followed in Italian tertiary allergy/asthma centers and adequately managed.

scholarly journals The real-world “ControL’Asma” study: a nationwide taskforce on asthma control in children and adolescents

2021 ◽  
Vol 49 (1) ◽  
pp. 32-39
Author(s):  
Maria Angela Tosca ◽  
Gian Luigi Marseglia ◽  
Giorgio Ciprandi ◽  
ControL’Asma” Study Group
Keyword(s):  
Lung Function ◽  
Children And Adolescents ◽  
Asthma Control ◽  
Real World ◽  
Asthma Management ◽  
Bronchial Obstruction ◽  
Control Test ◽  
Asthma Control Test ◽  
Study Objective ◽  
Asthmatic Children

Background: Asthma control is the goal of asthma management. A nationwide study on this aspect was launched by the Italian Society of Paediatric Allergy and Immunology (ControL’Asma study). Objective: To define variables associated with different asthma control grades in a nationwide population of asthmatic children and adolescents. Methods: This cross-sectional real-world study included 480 asthmatic children and adolescents (333 males, median age 11.2 years) consecutively enrolled in 10 third level pediatric allergy clinics. According to the Global Initiative for Asthma (GINA) document, history, medication use, perception of asthma symptoms assessed by visual analog scale (VAS), clinical examination, lung function, childhood asthma control test (cACT)/asthma control test (ACT), and asthma control level were evaluated. Results: Considering GINA criteria, asthma was well controlled in 55% of patients, partly controlled in 32.4%, and uncontrolled in 12.6%. Regarding cACT/ACT, asthma was uncontrolled in 23.2%. Patients with uncontrolled asthma had the lowest lung function parameters and VAS scores, more frequent bronchial obstruction and reversibility, and used more oral and inhaled corticosteroids (CS). Conclusions: The ControL’Asma study, performed in a real-world setting, showed that asthma in Italian children and adolescents was usually more frequent in males. Asthmatic patients had an early onset and allergic phenotype with very frequent rhinitis comorbidity. Uncontrolled and partly controlled asthma affected about half of the subjects, and the assessment of asthma symptom perception by VAS could be a reliable tool in asthma management.

scholarly journals Lung function and asthma control in school-age children managed in UK primary care: a cohort study

Thorax ◽  
2019 ◽  
Vol 75 (2) ◽  
pp. 101-107 ◽  
Author(s):  
David KH Lo ◽  
Caroline S Beardsmore ◽  
Damian Roland ◽  
Mathew Richardson ◽  
Yaling Yang ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Lung Function ◽  
Asthma Control ◽  
School Age Children ◽  
Act Scores ◽  
Asthma Control Test ◽  
Healthcare Settings ◽  
Children With Asthma ◽  
Observational Cohort

BackgroundSpirometry and fraction of exhaled nitric oxide (FeNO) are commonly used in specialist centres to monitor children with asthma. The National Institute for Health and Care Excellence recommends spirometry for asthma monitoring from 5 years in all healthcare settings. There is little spirometry and FeNO data in children managed for asthma in UK primary care to support their use.ObjectivesTo study the prevalence of abnormal spirometry and FeNO in children with asthma managed in primary care and to explore their relationship with asthma control and unplanned healthcare attendances (UHA).MethodsProspective observational cohort study in children aged 5–16 years with suspected or doctor-diagnosed asthma attending an asthma review in UK general practice. Spirometry, FeNO, asthma control test (ACT) scores and number of UHAs were studied.ResultsOf 612 children from 10 general practices, 23.5% had abnormal spirometry, 36.0% had raised FeNO ≥35 parts per billion and 41.8% reported poor control. Fifty-four per cent of children reporting good asthma control had abnormal spirometry and/or raised FeNO. At follow-up, the mean number of UHAs fell from 0.31/child in the 6 months preceding review to 0.20/child over the 6 months following review (p=0.0004). Median ACT scores improved from 20 to 22 (p=0.032), and children’s ACT from 21 to 23 (p<0.0001).ConclusionsAbnormal lung function and FeNO are common in children attending for asthma review in primary care and relate poorly to symptom scores. A symptoms-based approach to asthma monitoring without objective testing is likely to miss children at high risk of future severe asthma attacks.

scholarly journals Heart rate recovery in asthmastic children and adolescents after clinical field test

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Élida Pereira Silva ◽  
Bruno Alvarenga Soares ◽  
Mariana M. Reimberg ◽  
Raphael Ritti-Dias ◽  
Karina Silva Nascimento ◽  
...  
Keyword(s):  
Heart Rate ◽  
Children And Adolescents ◽  
Asthma Control ◽  
Functional Capacity ◽  
Heart Rate Recovery ◽  
Statistical Significance ◽  
Categorical Variables ◽  
Control Group ◽  
Asthma Control Test ◽  
Asthmatic Children

Abstract Background Inflammation caused by chronic lung disease in childhood may lead to delayed heart rate recovery (HRR) however, there is lack of evidence on HRR in this population. The aim was to assess HRR after functional capacity testing in asthmatic children and adolescents and to compare with severity and disease control. Method This was a study secondary to a randomized control trial. The modified shuttle test (MST) was performed to assess functional capacity and HRR. This is an externally cadenced test in which the distance walked is the outcome. HRR was assessed after MST and was defined as HR at exercise peak minus HR in the second minute after the end of exercise. Asthma control was assessed by the Asthma Control Test (ACT). Data normality was tested by Shapiro Wilk and the comparison between groups was made by Student’s t test or Mann Whitney test for numerical variables, and by Chi-square test for categorical variables. Statistical significance was considered when p < 0.05. SPSS version 20 was used in the analyzes. Results The sample included 77 patients diagnosed with asthma (asthma group - AG) who were regularly treated for asthma. Control group (CG) consisted of 44 volunteers considered healthy, matched in age and gender to AG. The median age of CG was 12 (10–14) years and in AG 11 (9–13 years) being classified as mild to moderate asthmatic, and 57% of the sample had controlled asthma by ACT. Distance walked in the CG was 952 ± 286 m and AG 799 ± 313 m, p = 0.001. HRR was more efficient in CG (79 ± 15 bpm) compared to AG (69 ± 12 bpm), p = 0.001. The mild (69 ± 12 beats) and severe (72 ± 15 beats) AG presented worse HRR compared to control group (79 ± 15 bpm), p < 0.05. Conclusions Asthmatic children and adolescents have delayed HRR after modified Shuttle test compared to their peers, suggesting that asthma leads to autonomic nervous system imbalance. Trial registration: Registered in Clinical Trials under number NCT02383069 and approved by the Universidade Nove de Julho - UNINOVE Research Ethics Committee, protocol number 738192/2014.

scholarly journals Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study

2019 ◽  
Vol 4 ◽  
pp. 168 ◽  
Author(s):  
Harriet Mpairwe ◽  
Pius Tumwesige ◽  
Milly Namutebi ◽  
Marble Nnaluwooza ◽  
Tonny Katongole ◽  
...  
Keyword(s):  
Asthma Control ◽  
Asthma Management ◽  
Cross Sectional Study ◽  
P Value ◽  
Asthma Diagnosis ◽  
Sectional Study ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Children With Asthma ◽  
Control And Management

Background: Children from low- and middle-income countries have poor asthma control, mainly because of poor management. The extent of this problem in Uganda is not well known, but such information would be useful to guide policy and practice. We therefore conducted a cross-sectional study among schoolchildren with asthma in urban Uganda, to assess the level of asthma control and management. Methods: Schoolchildren aged 5-17 years were enrolled, asthma was diagnosed by the study medical team. Asthma control was assessed using the Asthma Control Test and the childhood Asthma Control Test. Data on previous asthma management was obtained using interviewer-led questionnaires. Data were analysed using multiple linear and multiple logistic regression. Results: We enrolled 561 children with asthma, of whom only 56% had ever had an asthma diagnosis. We categorised asthma as well-controlled (55.5%), partly-controlled (29.5%) and poorly-controlled (15.0%). Poor asthma control was associated with increasing age (adjusted regression coefficient [95% confidence interval], p-value: -1.07 [-1.20, -0.94], p<0.0001), concurrent allergic rhinitis (-1.33 [-2.28, -0.38], p=0.006), and city residence in early life (-1.99 [-3.69, -0.29], p=0.06). Regular use of inhaled asthma medication in the last 12 months was very low; 18.1% for salbutamol and 6.7% for inhaled corticosteroids. The main barriers to inhaled asthma medication use were lack of prescription (47.6%) and inaccurate diagnosis (38.8%). Increased inhaler use was associated with tertiary education of the fathers (adjusted odds ratio [95% confidence interval], p-value: 5.19 [2.39-11.28], p<0.0001), city residence in early life (4.66 [1.79-12.43], 0.002) and an asthma diagnosis prior to enrolment (11.39 [6.35-20.43], p<0.0001). Conclusions: This study confirms that children with asthma in Uganda generally have inadequate asthma control, which is attributable to poor asthma management. This could be improved through re-training of medical workers and patient education, and by increasing availability and affordability of essential asthma medications.

scholarly journals Assessment of disease control in patients with asthma

Medicina ◽  
2009 ◽  
Vol 45 (12) ◽  
pp. 943 ◽  
Author(s):  
Guoda Pilkauskaitė ◽  
Kęstutis Malakauskas ◽  
Raimundas Sakalauskas
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Control Level ◽  
Asthma Management ◽  
Control Test ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Inhaled Steroids ◽  
Asthma Patients ◽  
Β2 Agonists

International guidelines indicate that the main criterion of asthma management is asthma control level. The aim of this study was to assess asthma control and its relation with age, gender, and lung function. Material and methods. A total of 106 family physicians and 13 pulmonologists and allergists took part in this study. Each doctor had selected 10–15 asthma patients and had sent invitations to them by post. On the visit day, the patients themselves filled in the Asthma Control Test. The doctors interviewed the patients and filled in a special questionnaire. Pulmonologists and allergists also assessed lung function by performing spirometry. According to the results of the Asthma Control Test, the disease control level was indicated as “totally controlled” (25 points), “well controlled” (24–20 points), and “uncontrolled” (19 points or less). Results. A total of 876 asthma patients were examined. Uncontrolled asthma was diagnosed to 56.2% of the patients, 36.5% of patients had well controlled and 7.3% totally controlled asthma. There was no significant difference in asthma control level comparing men and women. A correlation between asthma control level and age was found revealing poorer asthma control in older patients. Ninety-five percent of patients were treated with inhaled steroids; most of them had used inhaled steroids in combination with long-acting β2 agonists. It was found that lung function correlated with clinical symptoms of asthma, the demand of shortacting β2 agonists, and asthma control level. Conclusion. The study showed that uncontrolled asthma was diagnosed to more than half of the patients, despite most of them used inhaled steroids. Asthma control was worsening with the age of patients with asthma and it correlated with lung function. We suggest that periodical assessment of asthma control should help to optimize asthma management.

DYNAMICS OF INFLAMMATORY-CELLULAR PROFILE OF THE INDUCED SPUTUM IN PATIENTS WITH BRONCHIAL ASTHMA AND COLD AIRWAY HYPERRESPONSIVENESS UNDER BASIC ANTI-INFLAMMATORY THERAPY

2016 ◽  
Vol 1 (60) ◽  
pp. 15-22 ◽  
Author(s):  
Приходько ◽  
Anna Prikhodko ◽  
Пирогов ◽  
Aleksey Pirogov ◽  
Перельман ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Airway Hyperresponsiveness ◽  
Good Control ◽  
Induced Sputum ◽  
Asthma Control Test ◽  
Clinical Criteria ◽  
Bronchial Inflammation ◽  
Before And After ◽  
Anti Inflammatory

The character of changes of inflammatory-cellular pattern of bronchial secretion in patients with asthma in association with cold airway hyperresponsiveness (CAHR) under the influence of standard therapy has been studied little. The aim of the present work is to study dynamics of cellular profile, neutrophilic component of bronchial inflammation under the combination therapy of asthmatics with CAHR. 12 asthma patients with CAHR were studied upon the number of cells of the induced sputum (IS), peroxidase, cytolytic and destructive activity of eosinophils and neutrophils in the sputum, lung function and asthma control with the help of questionnaire Asthma Control Test (АСТ) before and after the therapy with the combination of budesonide/formoterol. Before the therapy the patients had a low level of asthma control (14.4±1.2 points of ACT), FEV1 was 87.4±3.3% from predicted values; in IS neutrophils prevailed (26.4±1.7%) over eosinophils (18.5±2.6%); the level of myeloperoxidase (mean cytochemical coefficient) was 65.9±5.4 pixels. After 48 weeks of the observation only in 58% of patients the criteria of good control of asthma and the improvement of lung function were achieved. In IS there was a decrease of eosinophils (11.4±3.2%; p=0.045); the intensiveness of eosinophils and neutrophils cytolysis dropped; intracellular concentration of myeloperoxidase grew (98.2±14.1 pixels; p=0.0637); destructive changes in granulocytes were registered but the number of neutrophils remained high (34.0±8.2%, р=0.34), which was considered as the factor of stable initiation of inflammation and oxidative stress. Thus, the use of anti-inflammatory treatment regime lasting 48 weeks with combination of budesonide/formoterol oriented to achieve clinical criteria of asthma control in patients with CAHR does not allow to achieve correction of the level of neutrophilic inflammatory component. Quantitative index of neutrophils in IS in these patients has prognostic value for the possible loss of achieved asthma control.

scholarly journals Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053100
Author(s):  
Reratilwe Ephenia Mphahlele ◽  
Omolemo Kitchin ◽  
R Masekela
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Control Test ◽  
Asthma Diagnosis ◽  
Asthma Control Test ◽  
Eligibility Criteria ◽  
Asthma Control Questionnaire ◽  
African Children

ObjectiveTo identify reasons for poor asthma control in African children and adolescents.DesignSystematic reviewData sourcesPubMed, Scopus, CINHAL, PsycINFO, MEDLINE and Web of Science databases were systematically searched up to 31 May 2020. Hand searching was done on Sabinet, African Journal online and Google Scholar.Eligibility criteriaStudies identifying barriers to asthma control, where asthma control was assessed by the validated Asthma Control Test/Child Asthma Control Test and/or Asthma Control Questionnaire were included.Data extraction and synthesisTwo reviewers independently selected studies for inclusion with disagreements resolved by a research team discussion, including a third reviewer. Data were extracted using the Cochrane Effective Practice and Organization of Care data collection form. The quality of the included studies was assessed using the modified Newcastle-Ottawa quality assessment scale. Identified barriers were reported in a thematic narrative synthesis.Primary outcomesPoorly controlled asthma and associated factors.ResultsFrom 914 records, three studies conducted between 2014 and 2019 in Nigeria, Uganda and South Africa met the inclusion criteria. A total of 883 children aged 4–19 years were analysed. Older age, concurrent allergy and city-dwelling significantly impacted asthma control. Few children with asthma symptoms in the community had ever used inhaled corticosteroids (6.7%) and identified reasons included lack of asthma diagnosis (38.8%) and no prescribed treatment (47.6%).ConclusionAsthma control in African children is impacted by age, allergy, urbanisation and lack of access to asthma diagnosis and treatment. More studies focusing on identifying barriers to asthma control in Africa are needed.PROSPERORegistration no: CRD42020196755)

scholarly journals Screen time above recommendations in children and adolescents: analysis of the associated nutritional, behavioral and parental factors

2020 ◽  
Vol 30 (3) ◽  
pp. 363-370
Author(s):  
Sonimar de Souza ◽  
Kelin Cristina Marques ◽  
Cézane Priscila Reuter
Keyword(s):  
Children And Adolescents ◽  
Screen Time ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Childhood And Adolescence ◽  
Parental Factors ◽  
Entire Family ◽  
Cross Sectional ◽  
Prevalence Of Obesity ◽  
Public Health Strategies

Introduction: Sedentary routines characterised by multimedia games favour an increase in the prevalence of obesity in schoolchildren and their parents. Thus, identifying the factors associated with screen time during childhood and adolescence is essential for the development of public health strategies. Objective: To analyse whether excessive time in front of screens in children and adolescents is associated with nutritional, behavioural and parental factors. Methods: Cross-sectional study on 795 schoolchildren, of which 354 were male, aged between 7 and 17 years, and their parents (father or mother) from a municipality in southern Brazil. The screen time spent by the students was self-reported, obtained in hours, considering excessive to be ≥ 2 hours a day. The parents’ nutritional profile was assessed in terms of body mass index (BMI). For the data analysis, the prevalence ratio (PR) was used and analysed using the Poisson regression, with 95% confidence intervals (CI). Results: We found a high frequency of overweight/obese students (30.9%), with low levels of cardiorespiratory fitness (53.7%), who spend ≥ 2 hours daily on the TV, computer or video games (57.1%). Screen time was associated with the prevalence of being overweight (PR = 1.06; CI = 1.00-1.13) and obesity (PR = 1.10; CI =: 1.03-1.18) among fathers, only among adolescents. Conclusion: Excessive screen time among adolescents was associated with the father’s nutritional status. It is suggested that strategies to reduce screen time should be implemented from childhood, involving the entire family.

scholarly journals Assessment of Asthma Control Using Asthma Control Test (ACT) and it Relationship with Lung Function Parameters

2013 ◽  
Vol 3 (8) ◽  
pp. 276-282
Author(s):  
Johnbull Jumbo ◽  
◽  
Bamidele Olaiya Adeniyi ◽  
Gregory Efosa Erhabor
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Control Test ◽  
Asthma Control Test

scholarly journals EVALUATION OF INDUCED SPUTUM CYTOLOGY IN ASTHMATIC CHILDREN

2021 ◽  
Author(s):  
Debora Carla Chong-Silva ◽  
Adriana Nascimento ◽  
Roberta Cunha ◽  
Elessandra Bitencourt ◽  
Leticia Botelho ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Pulmonary Function Tests ◽  
Sputum Cytology ◽  
Asthma Control Test ◽  
Sputum Induction ◽  
Hypertonic Saline Solution ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Children With Asthma

Objective: To evaluate the viability of sputum cytology in asthmatic children, recognizing inflammatory patterns and correlating them with clinical, epidemiological and functional variables of the disease. Methods: This was a cross-sectional and observational study of children with asthma who underwent sputum induction through increasing concentrations of nebulized hypertonic saline solution from 3% to 7%. The samples were processed according to the technique developed by Pizzichini et al. and the cytological pattern classified as pauci-granulocytic, neutrophilic, eosinophilic and mixed. Samples with cell viability> 50% were considered adequate. Asthma control was assessed using the asthma control test (ACT). Results: Seventy-nine children performed sputum induction. Thirty-three samples were excluded because they were not viable for analysis, resulting in 46 samples. The children’s average age was 9.4 (± 3) years. There was a predominance of eosinophilic (25/46, 54.3%), followed by mixed (13/46, 28.3%), pauci-granulocytic (7/46, 15.2%) and neutrophilic (1/46, 2.2%) pattern. Sixty-three percent of the children had severe asthma and 84.7% were treated with inhaled corticosteroids. The ACT showed that 25 (56.8%) patients had the disease under control. Forty-five children (97.8%) underwent pulmonary function tests (spirometry) and in 13 cases (28.9%) an obstructive ventilatory defect was found. Conclusions: The eosinophilic profile was predominant in the assessed asthmatic children. Non-eosinophilic phenotypes were found, but less frequently. There was no difference between the clinical variables and the sputum profile in this study group. Sputum induction in children with asthma is feasible and safe and can contribute to a specific and personalized approach to the disease.

Sign in / Sign up

Export Citation Format

Share Document